40 Years of NREMT Certification

Rubicon Bob

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Today I received my certificate for 40 Years of NREMT Certification

Seems to be much hatred for NREMT by EMS folks, which always amazes me

I received my

NREMT-A in 1983 and

NREMT-P in 1984



40 Years NREMT - REDACTED.jpg
40 Years NREMT Certificate - REDACTED.jpg
 
That's really impressive! What state mandated NREMT back in 1983?
 
That's really impressive! What state mandated NREMT back in 1983?

Thank you!

I'm from PA, it was not mandatory, it was voluntary.

I've never regretted obtaining, and maintaining it

When I went to NJ in 1990, for a Part-time Medic gig (was there for 27 years), NREMT made it very easy to get my NJ MIC-P cert
 
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I don’t hate NREMT per se, but I think it’s a needless organization. State scope of practice and education curriculums remain unique to each stare, and NREMT certification does not automatically grant state certification.

The board of nursing got it right. National curriculum and scope of practice and when I got my RN license I clicked a box and was automatically licensed in like 40 states.

Until NREMT brings everyone onto the same page, it really serves little purpose other than exam generation.
 
I don’t hate NREMT per se, but I think it’s a needless organization. State scope of practice and education curriculums remain unique to each stare, and NREMT certification does not automatically grant state certification.

The board of nursing got it right. National curriculum and scope of practice and when I got my RN license I clicked a box and was automatically licensed in like 40 states.

Until NREMT brings everyone onto the same page, it really serves little purpose other than exam generation.

I'll attach my response from 2020 about NREMT, I think it covers this

2020-08-14 - NREMT Response .jpg
 
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I'll attach my response from 2020 about NREMT, I think it covers this

View attachment 5823
I passed it originally and then I passed it without studying again in 2012 without cracking a book when I needed to get it back for AirEvac. Again, I don’t hate it, but it’s really nothing more than a badge of honor.

To address your side point, if we really want to make ourselves more professional, we’d have an actual national accrediting body with teeth and standard scope of practice. Instead the registry bows to the states meaning they really don’t serve any purpose.
 
I passed it originally and then I passed it without studying again in 2012 without cracking a book when I needed to get it back for AirEvac. Again, I don’t hate it, but it’s really nothing more than a badge of honor.

To address your side point, if we really want to make ourselves more professional, we’d have an actual national accrediting body with teeth and standard scope of practice. Instead the registry bows to the states meaning they really don’t serve any purpose.

Fair enough, everyone is entitled to their opinion.

But I am curious, if it's so useless, why did you need to take it AGAIN for AirEvac?

Sure sounds to me like it has some use, and it CERTAINLY has had use for me, for over 40 years........
 
Fair enough, everyone is entitled to their opinion.

But I am curious, if it's so useless, why did you need to take it AGAIN for AirEvac?

Sure sounds to me like it has some use, and it CERTAINLY has had use for me, for over 40 years........
Because I was at a base on the border of my state and the next one over and I needed to get my certification in the other state. That state, like a few others, uses national registry as their written exam.
 
To address your side point, if we really want to make ourselves more professional, we’d have an actual national accrediting body with teeth and standard scope of practice. Instead the registry bows to the states meaning they really don’t serve any purpose.
And, they would mandate a 2-year degree program for “entry-level” paramedics, and a 4-year degree for advanced providers (flight/ crit. care/ community/ administrative paramedics).

Yes, i know…a broken record. That said, I’ve kept my NREMTP for nearly 20 years. It helped, a lot, with choosing which undergrad program to choose.
 
And, they would mandate a 2-year degree program for “entry-level” paramedics, and a 4-year degree for advanced providers (flight/ crit. care/ community/ administrative paramedics).

Yes, i know…a broken record. That said, I’ve kept my NREMTP for nearly 20 years. It helped, a lot, with choosing which undergrad program to choose.
How did your NREMT influence your college choice?
 
How did your NREMT influence your college choice?
By honoring the most amount of college credits for my NR. That coupled with the small amount of college transcripts I was able to transfer even after a long layoff allowed me to cut my program in half.

Otherwise, I may have gone with a program closer to my home state that had a wider range of clinical classes (e.g., critical care and wilderness medicine), but I am actually enjoying most the EMS management coursework and pathway.

It’s also helping quite a bit given my current position. Also, i get enough critical care training throughout the year for free so it would have been redundant learning.
 
When I worked for the regional office that processed certifications for new providers and for those entering the state needing reciprocity, the National Registry served as the gateway into the system. If you finished a class, you had to complete the National Registry to get certified. If you already had National Registry certification, getting reciprocity was easy.

That said, I believe the National Registry often oversteps its boundaries and needs to stay in its lane. Their role should be limited to providing a validated cognitive exam—nothing more. They should not have any involvement in accreditation or continuing education. Their focus should remain on their core purpose, and they should let other entities handle the rest.
 
Because I was at a base on the border of my state and the next one over and I needed to get my certification in the other state. That state, like a few others, uses national registry as their written exam.

Last I knew (it might be different now) it was somewhere around 45 states used the NREMT test for Paramedic

Didn't you just tell AirEvac, and the border state, that NREMT is a needless test, and that you don't need to take a needless test, from a needless organization?
 
Clarifying:

NR helped me lop off the paramedic part of my degree pathway. The degree itself is helping with the rest.

The organization itself, IMO after being “nationally certified” for this long leaves much to be desired in the way of a professional organization.

I do believe it can and should do much more for the advocacy of the profession, and act like an organization that wants to better the profession.

This might be the beef a lot of folks in EMS, presumably career-minded ones with a penchant for progess, have with the NR.

All that said, absolutely nothing wrong with holding that certificate proudly. You do you, congrats on four decades.
 
Last I knew (it might be different now) it was somewhere around 45 states used the NREMT test for Paramedic

Didn't you just tell AirEvac, and the border state, that NREMT is a needless test, and that you don't need to take a needless test, from a needless organization?
I take it you glossed over my original point that exam generation is the only purpose the serve? I’m sorry you’re taking this so personally, but you’re not likely to change my mind..
 
I take it you glossed over my original point that exam generation is the only purpose the serve? I’m sorry you’re taking this so personally, but you’re not likely to change my mind..

I've heard similar, and many other things, for 40+ years

As I said, in the 80's and 90's it usually was from those that couldn't pass the test (not all, but most)

I knew some that did pass, but then were too lazy to get the few hours of Con-Ed to maintain

The best part, to me anyway, was when they'd go to move to another state and need to re-test, seems pretty silly to me

Now it just seems to be "the in thing" to hate on NREMT

I have, in my 46 years of EMS, found that many wish to maintain at the lowest level possible

I realize that perhaps NREMT hasn't become everything, to everybody, but perhaps if people would support NREMT, they could make it what they want

Tell me what EMS organization, that we have now, is in a better position to make things happen on the National level?
 
The board of nursing got it right. National curriculum and scope of practice and when I got my RN license I clicked a box and was automatically licensed in like 40 states.
National scope of practice? how many nurses can intubate? I know MICNs can... but it's not universal. And before you say it I know that not every nurse needs to be able to intubate, but my point was, the scope of practice isn't the same for everyone. That being said, the entry level standards are pretty much the same for everyone (which is similar to EMS).
To address your side point, if we really want to make ourselves more professional, we’d have an actual national accrediting body with teeth and standard scope of practice. Instead the registry bows to the states meaning they really don’t serve any purpose.
looking quickly on the internet, it appears that nursing licenses are still done at the state level, exactly like EMS. in fact, when I go to https://www.ncsbn.org/nursing-regulation/about-nursing-regulatory-bodies.page, it says "Nursing Regulatory Bodies (NRBs) are jurisdictional governmental agencies in the 50 states, the District of Columbia and four US territories that are responsible for the regulation of nursing practice. " and "
Each jurisdiction has a law called the Nurse Practice Act, which is enforced by each NRB. Nurses must comply with the law and related rules in order to maintain their licenses. The law describes:

  • Qualifications for licensure
  • Nursing titles that are allowed to be used
  • Scope of practice (what the nurse is allowed to do)
  • Actions that can or will happen if the nurse does not follow the nursing law"
even https://www.ncsbn.org/nursing-regulation/licensure.page says that the NCLEX-RN is only the test part, and you still need to apply for licensure with the appropriate jurisdictional agency.

I might be wrong; you're an RN, with first hand experience, and I can only go with what I read on the internet.

I think NR is good as a testing agency, as it says each provider much pass the same basic and entry level exam, which results in every EMT, Paramedic, etc, having the same baseline knowledge. I haven't seen much benefit to maintaining your NR, unless you are planning to move, or live/work near a state border, as the CEs for NR don't always line up with your local state's CE requirements.

I don't hate the NR, but I do think it's a nationally recognized exam, which is more widely recognized than a state exam, and it's standardized across all 50 states, while some individual state exams might be easier or harder, or held to different standards.
 
I've heard similar, and many other things, for 40+ years

As I said, in the 80's and 90's it usually was from those that couldn't pass the test (not all, but most)

I knew some that did pass, but then were too lazy to get the few hours of Con-Ed to maintain

The best part, to me anyway, was when they'd go to move to another state and need to re-test, seems pretty silly to me

Now it just seems to be "the in thing" to hate on NREMT

I have, in my 46 years of EMS, found that many wish to maintain at the lowest level possible

I realize that perhaps NREMT hasn't become everything, to everybody, but perhaps if people would support NREMT, they could make it what they want

Tell me what EMS organization, that we have now, is in a better position to make things happen on the National level?
Congrats on 40 years. That's definitely a rare milestone.

I've been one of the "haters" for a long time and it definitely has never been because I had any trouble passing the exams. I passed easily on my first attempt shortly after finishing paramedic school, in a state in which it wasn't required. I was gung-ho about my new career and wanted to collect as many feathers in my cap as possible. I also easily passed again when I had let it lapse for several years but needed it for certification in a new state that my service covered. It was also never about being too "lazy" to get the con-ed that I needed to recert or about wanting to just do the minimum; the education that I did to obtain and maintain my other credentials (state, CCEMTP, FP-C, CCRN, CFRN, etc) more than covered what I needed for NR recert. I think that's probably the case for most paramedics - you are doing con-ed of some sort anyway because its required by your service or your county or your state, so keeping NR doesn't require extra education, it's just the hassle of submitting everything and spending the time and money on a redundant credential.

The idea of having a single national credentialing body for EMS providers makes perfect sense and if having NR really made practicing in multiple states much easier than I'd be a big supporter. However, after a handful of recert cycles it became hard to ignore the many areas in which the NR was lacking. The 2-year recert cycles are ridiculously short; I'm not aware of any other professional credentialing organization that requires you to re-validate essentially your entire education every other year. The "distributive education" limits should have gone away in the 1990's but instead were maintained for another quarter century. The NR didn't seem to have any success pushing higher educational standards in the industry (which IMO should very much be part of the mission of such an organization) or becoming the national certifying body that we all hoped for. Finally, even though having NR did make reciprocity easier in many cases, most states still required state certification and the patchwork of different requirements from state to state made the NR pretty much redundant and often ineffective at the primary thing it ostensibly exists to achieve. Maintaining it became a necessary evil but a chore that didn't seem to bring much benefit at all.

The fact that having NR sometimes make it easier to certify in a new state isn't evidence for the organization's effectiveness, because if NR didn't exist, NR states would be forced to develop other pathways for reciprocity and you'd just follow whatever that was. You'd still get your new state cert and you wouldn't have to maintain redundant certification though a second organization .
 
Congrats on 40 years. That's definitely a rare milestone.

I've been one of the "haters" for a long time and it definitely has never been because I had any trouble passing the exams. I passed easily on my first attempt shortly after finishing paramedic school, in a state in which it wasn't required. I was gung-ho about my new career and wanted to collect as many feathers in my cap as possible. I also easily passed again when I had let it lapse for several years but needed it for certification in a new state that my service covered. It was also never about being too "lazy" to get the con-ed that I needed to recert or about wanting to just do the minimum; the education that I did to obtain and maintain my other credentials (state, CCEMTP, FP-C, CCRN, CFRN, etc) more than covered what I needed for NR recert. I think that's probably the case for most paramedics - you are doing con-ed of some sort anyway because its required by your service or your county or your state, so keeping NR doesn't require extra education, it's just the hassle of submitting everything and spending the time and money on a redundant credential.

Thank you!

As I said, I realize not all were due to failing, but in the 80's and 90's, in MY experience, the vast majority were due to failing

I am from PA, which was NOT a state that required NREMT in 1984, in fact PA had 2 levels of Paramedic then, Paramedic-I and Paramedic-II

Paramedic-I's did not meet criteria to sit for the NREMT-P exam, which created much resentment from many PA P-I's (Paramedic-I's)

Many PA systems back then ran Medics that were only P-I's

I also maintain my FP-C, CCP-C, and CCEMT-P, along with my NRP, never really found any of them difficult to maintain

When I worked in NJ, it was interesting to watch, as to those that maintained NREMT-P vs. those that didn't.

They (in the NJ service I worked for) held weekend programs for recert, Sat only for NJ MIC-P and both days for NREMT-P, I fail to understand how 1 extra day every 2 years is that big a deal, but apparently it is

Just to make you aware, NJ MIC-P is a 2-year recert

To be clear, I get it, if you're a volunteer or Part-timer (in other words, you don't pay your bills from your EMS job), why you wouldn't have or maintain NREMT

BUT, I do fail to understand why someone who is Career EMS, is unwilling to maintain NREMT certification

Again, just my opinion, and you are certainly intitled to yours
 
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National scope of practice? how many nurses can intubate? I know MICNs can... but it's not universal. And before you say it I know that not every nurse needs to be able to intubate, but my point was, the scope of practice isn't the same for everyone. That being said, the entry level standards are pretty much the same for everyone (which is similar to EMS).

looking quickly on the internet, it appears that nursing licenses are still done at the state level, exactly like EMS. in fact, when I go to https://www.ncsbn.org/nursing-regulation/about-nursing-regulatory-bodies.page, it says "Nursing Regulatory Bodies (NRBs) are jurisdictional governmental agencies in the 50 states, the District of Columbia and four US territories that are responsible for the regulation of nursing practice. " and "
Each jurisdiction has a law called the Nurse Practice Act, which is enforced by each NRB. Nurses must comply with the law and related rules in order to maintain their licenses. The law describes:
It's hilarious that after all these years, ability to intubate is still the very first thing brought up in almost any discussion comparing nurses and paramedics :cool:

The NCBSN (very loosely analogous to the NREMT) is what I think he is referring to and they do publish minimum scope of practice standards which influence the educational standards put out by the AACN, which is the primary credentialing body for nursing programs. They also write and administer the NCLEX, which is the board exam that every RN has to pass, loosely analogous to the NREMT exam, except that every state honors it and I fact there is no other pathway to becoming an RN that I am aware of.

Where things differ bigly between nursing and paramedic educational and credentialing is that there is a single national agency (AACN) that essentially dictates all nursing educational standards and a single national agency that writes and administers the board exam, and then once you pass that board exam, there are very few variances in requirements for licensure from state to state. In fact, there are 43 "compact states" where as long as you are licensed in one of them you can practice in any of these others with no need to obtain additional license or certification.

If it worked the same way in EMS, you'd take the NREMT exam once, use that to apply for certification in your home state, and then be able to practice in any of 43 other states with no additional credentialing needed.

Yes, each state has their own BON and Nurse Practice Act which is the actual law under which nurses in that state practice. Scope of practice varies some but the differences state to state are mostly administrative and your actual scope (skills you are allowed to do) is primarily dictated by your employer.
 
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